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The undeserved doubt of the antivaxxer

by Patrick Stokes
17 October 2015
HEALTH AND MEDICINE

Anti-vaccination activists have been outraged by policies they find unfairly coercive. They demand the right to make decisions based on their beliefs. Patrick Stokes has argued with anti-vaxxers for years. He doesn’t think they have any right to their unscientific opinions. 
 
For the last three years or so I’ve been arguing with anti-vaccination activists. In the process I’ve learnt a great deal – about science denial, the motivations of alternative belief systems and the sheer resilience of falsehood.
 
Since October 2012 I’ve also been actively involved in Stop the AVN (SAVN). SAVN was founded to counter the nonsense spread by the Australian Vaccination-skeptics Network. According to anti-vaxxers SAVN is a Big Pharma-funded “hate group” populated by professional trolls who stamp on their right to free speech.

I’m afraid the facts are far more prosaic. There’s no Big Pharma involvement – in fact there’s no funding at all. We’re just an informal group of passionate people from all walks of life (including several research scientists and medical professionals) who got fed up with people spreading dangerous untruths and decided to speak out.
 
When SAVN started in 2009, antivax activists were regularly appearing in the media for the sake of ‘balance’. This fostered the impression of scientific controversy where none existed. Nowadays the media understand the harm of false balance and the antivaxxers are usually told to stay home.
 
There’s a greater understanding that scientists are best placed to say whether or not something is scientifically controversial. (Sadly we can’t yet say the same for the discussion around climate change.) And there’s much greater awareness of how wrong – and how harmful – antivax beliefs really are.
 
No Jab, No Pay

This shift in attitudes has been followed by significant legislative change. Last year New South Wales introduced ‘No Jab, No Play’ rules. These gave childcare centres the power to refuse to enrol non-vaccinated children. Queensland and Victoria are planning to follow suit.
 
In April the Abbott government introduced 'No Jab, No Pay' legislation. Conscientious objectors to vaccination could no longer access the Supplement to the Family Tax Benefit Part A payment.
 
The payment has been conditional on children being vaccinated since 2012, as was the payment it replaced. But until now vaccination refusers could still access the supplement by having a ‘conscientious objection’ form signed by a GP or claiming a religious belief exemption. The new legislation removes all but medical exemptions.
 
The change closes loopholes that should never have been there in the first place. Claiming a vaccination supplement without vaccinating is rather like a childless person insisting on being paid the Baby Bonus despite being morally opposed to parenthood.
 
The new rules also make the Child Care Benefit (CCB) and Child Care Rebate (CCR) conditional on vaccinating children. That’s not a trivial impost – estimates at the time of the announcement suggested some families could lose around $15,000 over four years
 
What should we make of this? A necessary response to an entrenched problem or a punitive overreaction?
 
Much of the academic criticism of the policy has been framed in terms of whether it will in fact improve vaccination rates. Conscientious objector numbers do now seem to be falling though it remains to be seen whether this is due to the new policies.
 
Embedded in this line of criticism are three premises:

 

  1. Improvements in the overall vaccination rate will come through targeting the merely “vaccine-hesitant” population.
  1. Targeting the smaller group of hard core vaccine refusers, accounting for around 2% of families, would be counterproductive.
  1. The hard core is beyond the reach of rational persuasion even via benefit cuts.
 
These are of course empirical questions and open to testing. I suspect the third assumption is true. It’s hard to see how someone who believes the entire medical profession and research sector is either corrupt, inept, or both, or that government and media deliberately hide ‘the Truth’, would ever be persuaded by evidence from just those sources. A few antivaxxers even believe the germ theory of disease itself is false. In such cases no amount of time spent with a GP explaining the facts is going to help.
 
They base their “choices” on beliefs ranging from the ridiculous to the repugnant, but their fundamental objection is that the new policies are coercive.

In recent years, antivax activists have tended to frame their objections to legislation like No Jab, No Pay in terms of individual rights and freedom of choice. Yes, they base their “choices” on beliefs ranging from the ridiculous to the repugnant (including the claim that Shaken Baby Syndrome is really the result of vaccination not child abuse), but their fundamental objection is that the new policies are coercive. They make the medical procedure of vaccination compulsory, which they regard as a violation of basic human rights.
 
Part of this isn’t in dispute – these measures are indeed coercive. Whether they amount to compulsory vaccination is a more complex question. In my view they do not because they withhold payments rather than issuing fines or other sanctions, though that can still be a serious form of coercive pressure. Such moves also have a disproportional impact on families who are less well-off, revealing a broader problem with using welfare to influence behaviour.
 
Nonetheless it’s not particularly controversial that the state can use some coercive power in pursuit of public health goals. It does so in a range of cases – from taxing cigarettes to fining people for not wearing seatbelts. Of course there is plenty of room for disagreement about how much coercion is acceptable. Recent discussion in Canberra about so-called “nanny state” laws reflects such debate.
 
But vaccination doesn’t fall into the nanny state category because vaccination decisions aren’t just made by and for individuals. Several different groups rely on herd immunity to protect them. Herd immunity can only be maintained if vaccination rates within the community are kept at high levels. By refusing to contribute to a collective good they enjoy, vaccine refusers provide a classic example of the Free Rider Problem.
 
No Jab, No Pay legislation is not about people making vaccination decisions for themselves, but on behalf of their children. The suggestion that parents have some sort of absolute right to make health decisions for their children just doesn’t hold water. Children aren’t property, nor are our rights to parent our children how we see fit absolute. No-one thinks the choice to abuse or starve one’s child should be protected, for example.
 
And that gives lie to the “pro-choice” argument against these laws – not all choices deserve respect. 

 
The suggestion that parents have some sort of absolute right to make health decisions for their children just doesn’t hold water. Children aren’t property, nor are our rights to parent our children how we see fit absolute.

Thinking in a Vacuum
 
The pro-choice argument depends on the unspoken assumption there is room for legitimate disagreement about the harms and benefits of vaccination. That gets us to the heart of what motivates a great deal of anti-vaccination activism – the issue of who gets to decide what is empirically true. 
 
Antivax belief may play on the basic human fears of hesitant parents but the specific contents of those beliefs don’t come out of nowhere. Much of it emerges from what sociologists have called the “cultic milieu” – a cultural space that trades in “forbidden” or “suppressed” knowledge. This milieu is held together by a common rejection of orthodoxy for the sake of rejecting orthodoxy. Believe whatever you want – so long as it’s not what the “mainstream” believes.
 
This sort of epistemic contrarianism might make you feel superior to the “sheeple”, the unawake masses too gullible, thick or corrupted to see what’s really going on. It might also introduce you to a network of like-minded people who can act as a buffer from criticism. But it’s also a betrayal of the social basis of knowledge – our radical epistemic interdependency.
 
The thinkers of the Enlightenment bid us sapere aude, to “dare to know” for ourselves. Knowledge was no longer going to be determined by religious or political authority, but by capital-r Reason. But that liberation kicked off a process of knowledge creation that became so enormous specialisation was inevitable. There is simply too much information now for any one of us to know it all.
 
Talk to antivaxxers and it becomes clear they’re stuck on page one of the Enlightenment project. As Emma Jane and Chris Fleming have recently argued, adherence to an Enlightenment conception of the individual autonomous knower drives much conspiracy theorizing. It’s what happens when the Enlightenment conception of the individual as sovereign reasoner and sole source of epistemic authority confronts a world too complex for any individual to understand everything.


As a result of this complexity we are reliant on the knowledge of others to understand the world. Even suspicion of individual claims, persons, or institutions only makes sense against massive background trust in what others tell us.
 
Accepting the benefits of science requires us to do something difficult – it requires us to accept the word of people we’ve never met who make claims we can never fully assess.

Accepting the benefits of science requires us to do something difficult – something nothing in our evolutionary heritage prepares us to do. It requires us to accept that the testimony of our direct senses no longer has primary authority. And it requires us to accept the word of people we’ve never met who make claims we can never fully assess.
 
Anti-vaxxers don’t like that loss of authority. They want to think for themselves, but they don’t accept we can’t think in a vacuum. We do our thinking against the background of shared standards and processes of reasoning, argument and testimony. Rejecting those standards by making claims that go against the findings of science without using science isn’t “critical thinking”. No more than picking up the ball and throwing it is “better soccer”. 
 
This point about authority tells us something ethically important too. Targeting the vaccine-hesitant rather than the hard core refusers makes a certain kind of empirical sense. But it’s important to remember the hard core are the source of the misinformation that misleads the hesitant. In the end the harm caused by antivax beliefs is due to people who abuse the responsibility that comes with free speech. Namely, the responsibility to only say things you’re entitled to believe are true.
 
Most antivaxxers are sincere in their beliefs. They honestly do think they’re doing the right thing by their children. That these beliefs are sincere, however, doesn’t entitle them to respect and forbearance. William Kingdon Clifford begins his classic 1877 essay The Ethics of Belief with a particularly striking thought experiment.
 

A shipowner was about to send to sea an emigrant-ship. He knew that she was old, and not well built at the first; that she had seen many seas and climes, and often had needed repairs. Doubts had been suggested to him that possibly she was not seaworthy. These doubts preyed upon his mind, and made him unhappy; he thought that perhaps he ought to have her thoroughly overhauled and refitted, even though this should put him at great expense. Before the ship sailed, however, he succeeded in overcoming these melancholy reflections. He said to himself that she had gone safely through so many voyages and weathered so many storms that it was idle to suppose she would not come safely home from this trip also. He would put his trust in Providence, which could hardly fail to protect all these unhappy families that were leaving their fatherland to seek for better times elsewhere. He would dismiss from his mind all ungenerous suspicions about the honesty of builders and contractors. In such ways he acquired a sincere and comfortable conviction that his vessel was thoroughly safe and seaworthy; he watched her departure with a light heart, and benevolent wishes for the success of the exiles in their strange new home that was to be; and he got his insurance-money when she went down in mid-ocean and told no tales.

Note that the ship owner isn’t lying. He honestly comes to believe his vessel is seaworthy. Yet Clifford argues, “the sincerity of his conviction can in no wise help him, because he had no right to believe on such evidence as was before him.”
 
In the twenty-first century nobody has the right to believe scientists are wrong about science without having earned that right through actually doing science. Real science, mind you, not untrained armchair speculation and frenetic googling. That applies as much to vaccination as it does to climate change, GMOs and everything else.
 
We can disagree about the policy responses to the science in these cases. We can also disagree about what financial consequences should flow from removing non-medical exemptions for vaccination refusers. But removing such exemptions sends a powerful signal. We are not obliged to respect harmful decisions grounded in unearned beliefs, particularly not when this harms children and the wider community.
 
 
Dr Patrick Stokes is a senior lecturer in Philosophy at Deakin University. Follow him on Twitter @patstokes.

20 Comments

Comments
Rebecca
Oh my. I had no idea that there was as much silliness in Australia over vaccinations.

Vaccinations have been PROVEN effective - you only need to look at the rates of vaccine preventable diseases to see that. Certainly some can be attributed to better techniques in medicine - but not the full amount - and doesn't explain why diseases have resurgences in our modern times, as vaccination levels drop.

How many commenters here, claiming that the professors 'extensive reading in philosophy' doesn't give him anything that you can't get with a few google searches, have a university degree? Have been through the academic rigor of a PhD? That isn't just 'extensive reading' - that is a massive workload, usually teaching, research, and a lot of writing - which is heavily scrutinised by many people. You can't just 'read' something - you have to prove you understand it, and can critique it.

You can google search all you like - you have access to more information now than any other time in human history. That doesn't mean you have access to CORRECT information though. You have to be able to critically evaluate the information you read - or you're going to just simply switch one form of ignorance for another. That isn't getting yourself an education.
23/11/2015 9:24:37 PM

The_Truth
Well, where to begin...the strategised filing of a piece like this under anything to do with "ethics" just has me just a little lost for words. Incalculable irony. The attempt of this particular author trying to paint themselves as 'philosophical' i.e. open minded , rather than plain old fanatic and biased, well that gives me a good belly laugh. "You are entitled to a belief, so long as it is what I believe in", is a mind tune that is so far regressed from any modern day "open minded" thinker that it rather stands on the polar end of any reasoned "ethics" scale, unfortunately on the polar end of what the author would otherwise like to portray. This alone, is befuddled and fanatic, but when you have somebody say that science and indeed medicine of any description is a closed topic, which cannot be touched, it alludes us an insight into the dangerous mind of a fanatic. Mindsets like this turns your perceived "science" into a religious cult, of no freedom of movement, not a science. Similar to a cult too, in that any deviation from the cult invokes an irrational intent to restrain and oppress, if not subject to demanding ultimatums. Totalitarianism and oppression, the very obstacles to freedom and democracy happen you take a mindset like this, and you add a dash of "let's make laws to confirm this mindset and this mindset only". It then most certainly takes on a sinister shade which cannot be left unchallenged. This is what is happening here. In Australia. Today. By the likes of Patrick Stokes and his esteemed kindred spirits. Who, exactly, is the "epistemic authority of science", Patrick Stokes? Does it belong to you, and people with your shared mindset only? Or is an authority of science somebody with enough awareness and level headed reasoning to realise that science is just a tool, of which there are a realm of possibilities. Vaccine science, unfortunately for you, is very much up for debate. Partly due to the massive inconsistencies, and partly due to the fact that they are largely understudied, especially for follow up and/or the chronic, long term effects of such, nor any studies done on the health of vaccinated versus unvaccinated children (apart from a German one which was incriminating - you wouldn't like those results). Then we are left with the fact that we cannot get any non-biased funding to undertake studies of a neutral agenda. Studies are flawed, with nearly all pharma funded studies failing to use a true placebo (instead of an aluminium adjuvent which has systemic effects). There are inadequacies in study methodology and insurmountable politics behind vaccines and neither of them pass the "Gold Standard Test" by any stretch of the imagination. But as another commentator said, lets just all park our brains at the door, and hand over our thinking caps and our rights to consent over to the "epistemic authorities of science" *cough cough*. Nothing to see here, move along. I mean who deserves the fundamental right to think for oneself, right?
6/11/2015 12:34:16 AM

Pro vaxer always.
I say let the antivaxes have their way open up childcare centres for them so they cant freeload off vaccinated children; and see if they become the breeding ground like old contagious diseases like polio, measles etc return. For at the moment they are free loading on those who vaccinate. When their children again start to die from measles, can't walk because of polio, get that dreaded meningitis .... they might realise that the science and medical professionals aren't full of bullshit. They actually save lives. I know my mother would have wished there was a vaccination for meningitis many years ago when my brother contracted it.
25/10/2015 5:19:41 PM

Patrick Stokes
Ilya: the epistemic authority isn't "granted by vote" (Gregory seems to be under this misapprehension too) nor is it subject to being arbitrarily rescinded. We're not - and I think this point needs to be very clear - talking about a political form of authority, as if everyone gets a vote on whether or not science delivers reliable answers.
25/10/2015 2:54:43 PM

Gregory Golberg
"It sure feels like someone's there, but I don't see anyone... Who's there?"
"It's the no-knock-epistemic-warrant SWAT team!"

When you say that "everyone who's commented here" "demonstrate precisely" that "ntivaxxers don't accept that the rise of science as society's sole legitimate source of empirical validation"...

Now, granting that there is such a thing like "the rise of science as society's sole legitimate source of empirical validation", I am sure it would not trouble you to show exactly how "Everone who's commented here" actually "demonstrated" that "precisely"?

As Mr.Mousebender once said, "It figures, pretty predictable, really; it was an act of pure optimism to have asked the question in the first place."

Mr Stokes, when you say:

"We're not, as you say, a technocracy - which would be a society that illegitimately takes science to deliver normative as well as descriptive facts - but we are a society that accepts the epistemic authority of science over certain sorts of questions. "Are vaccines safe and effective?" is such a question: you can't answer a question like that from outside of science, and non-scientific answers that contradict what the science says are therefore of no value."

Do you mean to suggest that "safe" is not a normative term? As for "effective", is it to be taken as a term of art, or in some sort of general usage? Like, a fire poker - it's definitely effective in stoking coals, but as for a philosophical argument... well, ok, bad example.

"To suggest otherwise, as some have already done here, is like saying that at the end of a football match you give the crowd a vote to determine who really won, regardless of what the scoreboard says. "

If the rules of the game can say the game is won by penalty shots today, they can, tomorrow, say that it is won by the fans cheering. What exactly do rules of some random game show?

"Of course we can't stop people holding beliefs for which they have no epistemic warrant; my point is that we aren't obliged to take those beliefs seriously."

Ok, but but how does this work with regards to a representative democracy? Mr Stokes will judge every political advert out there?

"And when people run around repeating beliefs that are demonstrably untrue and that cause harm, they deserve to be held to account for that."

If we hold this, then, perhaps, we should start with politicians? Or, to take baby steps, maybe with jury trials?
22/10/2015 4:22:39 PM

Mattie G
“Conscientious objector numbers do now seem to be falling though it remains to be seen whether this is due to the new policies.”

I missed this first time through. You actually quoted Jane Hansen’s “downward trend”. hahaha Trend doesn’t mean what she thinks it means.

“The pro-choice argument depends on the unspoken assumption there is room for legitimate disagreement about the harms and benefits of vaccination. That gets us to the heart of what motivates a great deal of anti-vaccination activism – the issue of who gets to decide what is empirically true. “

The anti-choice argument depends on the assumption that there isn’t room for legitimate disagreement, and that VACCINES SAVE LIVES and THE SCIENCE IS SETTLED. Anti-choice activism is informed by decisions about who gets to decide what is empirically true, and that people who have spent a long term in universities are the only people capable of meeting this criteria. hahahahaha


“Antivax belief may play on the basic human fears of hesitant parents but the specific contents of those beliefs don’t come out of nowhere.”

Fears? What about good old fashioned scepticism that the insertion of a depot of various chemicals, metals and biological substances into one’s arm is not going to enhance one’s health?

“Much of it emerges from what sociologists have called the “cultic milieu” – a cultural space that trades in “forbidden” or “suppressed” knowledge. This milieu is held together by a common rejection of orthodoxy for the sake of rejecting orthodoxy. Believe whatever you want – so long as it’s not what the “mainstream” believes.”

What a load of %*$# Patrick. Anti-vaxers hold many mainstream beliefs. If they didn’t, how come they fly in planes and use the internet? Notwithstanding that I myself have a strong oppositional tendency, I am compliant with many mainstream practices and moral codes, and this is the case for most anti-vaxers I know. My oppositional tendency tends to manifest only in the presence of overt and unjust authoritarian pressure. I even believe in the concept of a social contract, but the presumption that this contract, by default, includes mass vaccination under authority of the medical profession is not justified.

“This sort of epistemic contrarianism might make you feel superior to the “sheeple”, the unawake masses too gullible, thick or corrupted to see what’s really going on.”

I feel superior, only because I have better reasoning skills than most pro-vaxers combined with the type of personality which doesn’t place too much importance on peer preferences/beliefs/need to fit in.

“It might also introduce you to a network of like-minded people who can act as a buffer from criticism.”

Given anti-vaxers are a tiny minority, you are over-stating the benefits such networks offer, but that’s because it suits your side to cast us as being all-powerful at influencing the masses over to our side. That argument is far more relevant to the pro-vaccine side.

“But it’s also a betrayal of the social basis of knowledge – our radical epistemic interdependency.
The thinkers of the Enlightenment bid us sapere aude, to “dare to know” for ourselves. Knowledge was no longer going to be determined by religious or political authority, but by capital-r Reason. But that liberation kicked off a process of knowledge creation that became so enormous specialisation was inevitable. There is simply too much information now for any one of us to know it all.”

You’ve made this argument before, but your reasoning is flawed. Doctors have far greater knowledge about the practice of medicine they have been taught, but I don’t need to have the same level of knowledge to make decisions about a single aspect of that practice. What I do need to know about is the methods which have been employed to give authority to a particular practice. In the case of vaccination, the method giving authority to the practice is largely flawed epidemiology using various assumptions.

Don’t you find it interesting that in one of the rare instances that experimental methodology has been employed to test a post-market vaccine, that it proved resoundingly that the vaccine didn’t work? I’m talking about the Whooping Cough Baboon study here, which clearly found that the vaccine neither prevented the colonisation of the bacteria or prevented its transmission despite the fact the medical profession had been claiming it did so for many years prior on the basis of flawed epidemiology which relied on data subject to significant ascertainment bias (notifications of VPD subject to diagnostic bias due to non-blinding).

Experimental methodology using placebo control groups forms the basis of the scientific method in relation to medicine, yet when it comes to vaccines this methodology is seldom used. In its place are models which rely on assumptions, such as the assumption that particular levels of antibodies indicate immunity to disease, even though no such experimental evidence supporting this assumption exists. In fact, there’s plenty of evidence to show that people with the alleged sufficient antibody levels have succumbed to the diseases to which they were allegedly immune. I won’t bother going into this further, except to say, I am under no obligation to accept practices which have been informed by methods which violate the basic scientific method. If you choose to on the basis you can’t possibly know everything about the practice of medicine and therefore must rely on experts, that’s your prerogative, but it should give you no right to feel smug or to debase the views of others who use different reasoning.

“Talk to antivaxxers and it becomes clear they’re stuck on page one of the Enlightenment project. As Emma Jane and Chris Fleming have recently argued, adherence to an Enlightenment conception of the individual autonomous knower drives much conspiracy theorizing. It’s what happens when the Enlightenment conception of the individual as sovereign reasoner and sole source of epistemic authority confronts a world too complex for any individual to understand everything.”

As stated above: False. Anti-vaxers rely on expertise/out-sourced decisions in many domains of their lives. I think you’re stuck in pre-internet academia.

“As a result of this complexity we are reliant on the knowledge of others to understand the world. Even suspicion of individual claims, persons, or institutions only makes sense against massive background trust in what others tell us. Accepting the benefits of science requires us to do something difficult – something nothing in our evolutionary heritage prepares us to do. It requires us to accept that the testimony of our direct senses no longer has primary authority. And it requires us to accept the word of people we’ve never met who make claims we can never fully assess.”

I am reliant on the knowledge and authority of the medical model only in emergency type situations. For example, if I was to cut my fingers off while using a circular saw. In most other situations where the authority of medicine may come into play, I’m under no such reliance. I am free to evaluate competing options in the same way I’m free to evaluate competing options for any other service or product. I do not accept that vaccination provides a benefit to a healthy person so I’m under no obligation to accept it.


There is absolutely zero evidence that people who refuse to vaccinate contribute to an overall increase of disease in the population.

Ecological niche theory (if one was to believe the germ theory as currently constructed) tells us that if one microbe is eliminated then it will be replaced by another, and that there will never be a net reduction in disease attributable to microbes. In the space of my life time, I’ve certainly observed this to be true. When I was growing up children were never diagnosed or hospitalised with diseases such as Hand Foot and Mouth Disease or RSV. Today, thousands are. I don’t see that the overall burden has decreased due to vaccination, and there’s no empirical evidence it has.

This theory can be adapted to non-germ theory models of disease as well: the reduction of one particular disease/condition will result in a concomitant increase in another. We still have high rates of disability and chronic disease in children, likely higher than pre-mass-vaccination, but different causes are attributed to them. Are we better off in this respect? I don’t believe so. Pre-mass-vaccination, sensory losses were frequently attributed to viruses such as Measles or Rubella whilst today these cases may be attribute to genetics.

“Anti-vaxxers don’t like that loss of authority. They want to think for themselves, but they don’t accept we can’t think in a vacuum. We do our thinking against the background of shared standards and processes of reasoning, argument and testimony. Rejecting those standards by making claims that go against the findings of science without using science isn’t “critical thinking”. No more than picking up the ball and throwing it is “better soccer”.

My distrust/scepticism of the medical profession/practice doesn’t represent a concern over a loss of authority, rather a fear I will be maimed or killed under the authority of medicine. These fears are not unfounded. Medical misadventure maims and kills many every year. This is undisputed. That this is done to otherwise healthy people in relation to vaccination under authority of medicine is even more concerning. It’s one thing to takes risks when one is sick, quite another when one is healthy.

“This point about authority tells us something ethically important too. Targeting the vaccine-hesitant rather than the hard core refusers makes a certain kind of empirical sense.”

I don’t care who is targeted as long as it isn’t me, but who the hell isn’t vaccine-hesitant. That is the default state surely.

“But it’s important to remember the hard core are the source of the misinformation that misleads the hesitant. In the end the harm caused by antivax beliefs is due to people who abuse the responsibility that comes with free speech. Namely, the responsibility to only say things you’re entitled to believe are true.”

Evidence please. Pro-vaccine beliefs have proliferated since social media as have vaccination rates. You just use this claim to support your abuse of anti-vaxers even though it has no basis in fact. Light for Riley is a case in point. Thousands of parents are submitting themselves to WC vaccination on the faith it will prevent WC in babies too young to be vaccinated, yet empirical evidence shows this to be false. Where is your outrage that Light for Riley are cultivating misinformation in the community?

“In the twenty-first century nobody has the right to believe scientists are wrong about science without having earned that right through actually doing science. Real science, mind you, not untrained armchair speculation and frenetic googling. That applies as much to vaccination as it does to climate change, GMOs and everything else.”

The contrary is true. In the 21st century, ordinary people have access to information that was once upon a time only available to select authorities/professions. We no longer need to rely on so-called experts to the same extent we did 50 years ago. This probably gets to the crux of the matter. Doctors and scientists don’t like the fact that their secret knowledge and expertise is now widely available on the world wide web. Hell, I could even become an expert Philosopher if I was so inclined, based on all of the information available on the web. You are locked into old models of education. The world is moving on from your preferred model of institutional and professional authority. Get with the times Patrick. Your extensive reading in Philosophy is not special anymore.

“We can disagree about the policy responses to the science in these cases. We can also disagree about what financial consequences should flow from removing non-medical exemptions for vaccination refusers. But removing such exemptions sends a powerful signal. We are not obliged to respect harmful decisions grounded in unearned beliefs, particularly not when this harms children and the wider community.”

We can disagree about whatever we want to bloody disagree about.


“Dr Patrick Stokes is a senior lecturer in Philosophy at Deakin University. Follow him on Twitter @patstokes.”

I would just love to see a plot of your follower numbers since attaching yourself to the SAVN bandwagon. I suspect it would reveal that SAVN has been very good for your numbers. hahhahahaha
22/10/2015 11:13:01 AM

Ilya Shlyakhter
Mr. Stokes - Forcing people to act against deep beliefs is a distinct harm, regardless of beliefs' truth. In the U.S., this harm is considered non-trivial: https://goo.gl/eiThUl . Balancing it against the harm of preventable disease is a normative question. So is risk perception; one man's safe is another's unsafe, for the same risk of the same outcome.

Acceptance of "the epistemic authority of science over certain sorts of questions" is granted by vote (e.g. by giving certain authority to the Health Department), and may be limited or rescinded. In the football match, we collectively appoint a referee; we may collectively un-appoint him. It is, of course, important that a legitimately appointed referee's calls be accepted.

The pro-choice argument fails not because "not all choices deserve respect", but because the relevant choice is inherently joint. The choice that determines your total risk, from vaccines and infections, is not whether you vaccinate, but whether vaccines are mandated. On that, you have no individual choice either way.
22/10/2015 8:43:43 AM

Patrick Stokes
Ilya, I did say in the articlethat people can reasonably disagree about the policy responses to science and about whether and to what extent coercive policy measures are appropriate, so I think we largely agree on that. We also agree that people have a right to vote for whatever reasons they want. But the formation of public policy has to be guided by reasons, and there are certain reasons we're simply not obliged to respect in that process. Unearned counter-scientific beliefs fall into that category. We're not, as you say, a technocracy - which would be a society that illegitimately takes science to deliver normative as well as descriptive facts - but we are a society that accepts the epistemic authority of science over certain sorts of questions. "Are vaccines safe and effective?" is such a question: you can't answer a question like that from outside of science, and non-scientific answers that contradict what the science says are therefore of no value. To suggest otherwise, as some have already done here, is like saying that at the end of a football match you give the crowd a vote to determine who really won, regardless of what the scoreboard says.

Of course we can't stop people holding beliefs for which they have no epistemic warrant; my point is that we aren't obliged to take those beliefs seriously. And when people run around repeating beliefs that are demonstrably untrue and that cause harm, they deserve to be held to account for that.
21/10/2015 10:38:41 AM

Ilya Shlyakhter
Mr. Stokes, your tone is offensive and counter-productive. I work in science and support the state's right to require vaccinations in some contexts. I've also spent months talking to anti-vaxxers, and can say that not all their points are absurd.

We're not a technocracy; people have an unreviewable right to vote for any candidate or initiative, based on any reasoning whatsoever. "Right to believe" is an oxymoron. Anti-vaxxers are well within their rights to question vaccine mandates. In exchange, if their questioning fails to convince the voters or the courts, they must accept the outcome as fair; it's frustrating when they don't. Most voters do trust science, and courts have standards for evaluating science, so the risk of unsupported outcome is small. But the right to raise questions is an essential quality control, and should not be curbed.

Anti-vaxxers raise some good questions, esp. about insufficient incentives to track and minimize vaccine injury. Unfortunately, their valid points get lost amid many invalid ones.
21/10/2015 6:34:56 AM

Patrick Stokes
My warmest thanks to everyone who's commented here. I'm grateful that you've taken a moment out of your day to demonstrate precisely the points I was making the article: namely, that antivaxxers don't accept that the rise of science as society's sole legitimate source of empirical validation means non-scientists' views on scientific questions don't carry any weight; that through denying the epistemic authority of science with respect to medical questions they negligently shirk their duty of care to their children and their responsibilities to the community; and they display generalised (and self-defeating) distrust in the essential knowledge-generating mechanisms of their societies. I couldn't have asked for a better demonstration. Much obliged!
20/10/2015 1:32:15 PM

Lisa
Every parent of a vaccine injured child was once 'pro-vaccine ' and trusted without questioning.
19/10/2015 9:30:32 PM

Tigerlily
Matty,

Thank you for taking the time to address this preposterous article masquerading as inviolable truth (aka, park your brain at the door kids, you won't be needing it here, we've got the experts to do all that pesky thinking for you). Beautifully spoken and well-referenced, and even a plebeian non-scientist like me can follow it ... miracles!
19/10/2015 9:16:40 PM

Gregory Golberg
First off, it is very convenient of the writer to say "In the twenty-first century nobody has the right to believe scientists are wrong about science without having earned that right through actually doing science. " In doing so, the esteemed Ethicist glosses over the fact that one may not be questioning whether scientists are wrong about science, but whether Mr.Stokes-the-blogger, or Mr.Jones-the-reporter, or Mr.Smith-the-legislator are cherry-picking the "science", and so on along the chain, before the average person is even allowed to utter a peep.

(Either Mr.Stokes did not think through this piece, which makes him a not-so-great philosopher, or he is pulling one over on us, which makes him a not-so-great ethicist).

But that's a minor quibble. A bigger one is this:

"It requires us to accept that the testimony of our direct senses no longer has primary authority. And it requires us to accept the word of people we’ve never met who make claims we can never fully assess."

Now imagine yourself as a patient. Please tell me there is not a direct "reasoning" from here to "symptoms don't matter"? Basically, this is a self-fulfilling prophecy (Mr.Stokes, I am sure, is paid for it handsomely) -- you report certain symptoms, but as they are not extant in any literature, they do not exist -- they must be in your head.
19/10/2015 2:51:09 PM

John Cunningham
No matter how passionately and vehemently people believe in things, it does not make that belief true. A child may believe in Santa Claus, but it doesn't mean that Santa exists. Sorry kids, and sorry anti-vaxxers.
19/10/2015 12:30:40 PM

Tim Dean
These comments serve to underscore Pat's very points nicely about false entitlement to beliefs without first accepting the responsibility to base those beliefs on evidence or reason.
19/10/2015 10:39:34 AM

Mattie G
Anti-vaccination activists have been outraged by policies they find unfairly coercive.”

Editor, it is incorrect to suggest that it is only anti-vaccination activists who are outraged by No Jab No Pay/Play laws. A pro-vaccine nurse family member of mine is similarly outraged that the government would see fit to intrude into decisions about invasive medical procedures. Likewise, my WWII veteran father, who lived through “Polio” is outraged.

“They demand the right to make decisions based on their beliefs.”

The horror of it all. How dare people have an expectation to make decisions based on their beliefs.

“Patrick Stokes has argued with anti-vaxxers for years. He doesn’t think they have any right to their unscientific opinions.”

He hasn’t just argued with anti-vaxxers, he has actively mocked and ridiculed them in fact. He believes that mocking and ridiculing people opposed to vaccination is legitimate and not a form of bullying, even though every school in Australia would consider such practices constitute bullying if students were doing so. He has an amazing ability to rationalise his disgraceful behaviour, as do all members of SAVN.

“For the last three years or so I’ve been arguing with anti-vaccination activists. In the process I’ve learnt a great deal – about science denial, the motivations of alternative belief systems and the sheer resilience of falsehood.”

Actually Patrick, you know very little about anti-vaxer belief systems you just think you do. For example, I would describe myself as a non-interventionist. By that I mean, I would need seriously compelling evidence before I would submit to any kind of medical procedure or drug intervention. For example, a small absolute risk reduction would be insufficient to convince me to accept a medical procedure to treat a disease, so there’s no way I would accept a procedure which doesn't even treat anything, and which only purports to have some questionable future benefit.

“Since October 2012 I’ve also been actively involved in Stop the AVN (SAVN). SAVN was founded to counter the nonsense spread by the Australian Vaccination-skeptics Network. According to anti-vaxxers SAVN is a Big Pharma-funded “hate group” populated by professional trolls who stamp on their right to free speech. I’m afraid the facts are far more prosaic. There’s no Big Pharma involvement – in fact there’s no funding at all. We’re just an informal group of passionate people from all walks of life (including several research scientists and medical professionals) who got fed up with people spreading dangerous untruths and decided to speak out.”

On certain occasions, SAVN has gone to great lengths to highlight the large number of its members who are doctors, nurses, scientists, researchers, yet now you’re saying that SAVN members are merely a group of "ordinary" people from all walks of life? What nonsense. There is a significant over-representation of professionals who earn their living from the pharmaceutical model of medicine among the ranks of SAVN. No way is SAVN a representative sample of the Australian population. So Yes, SAVN has significant ties with Big Pharma, if not in a direct sense, then in a indirect one. For example, Katie Attwell, whose recently published research into the impact of the ‘I Immunise’ campaign in Western Australia, has ties with Big Pharma, in that her research was funded in part by Sanofi Pasteur.

“When SAVN started in 2009, antivax activists were regularly appearing in the media for the sake of ‘balance’. This fostered the impression of scientific controversy where none existed. Nowadays the media understand the harm of false balance and the antivaxxers are usually told to stay home.”

So SAVN conspired with the media to eliminate “false balance” yet there is no conspiracy? Righto, got it.

“There’s a greater understanding that scientists are best placed to say whether or not something scientifically controversial. (Sadly we can’t yet say the same for the discussion around climate change.)”

Actually Patrick, the opposite is true. Most scientists are too heavily invested in their own beliefs that they are incapable of identifying flaws in their models and assumptions. That is why independent watchdogs, and not peerage-review is vitally important, but unfortunately independent review of the claims of the medical establishment is virtually non-existent in Australia. The TGA basically accepts the claims of the pharmaceutical companies because they do not have any source of funding that would permit them to conduct independent analysis.

Ben Goldacre has stated the whole edifice of medicine is broken, yet for some strange reason that statement doesn’t apply to the practice of vaccination. Curious that. Similarly, Peter C Gotzsche, from the Norwegian section of the Cochrane Collaboration, has described Big Pharma corruption of medicine as a form of organised crime, but as with Goldacre, he’s avoided including vaccination under this umbrella. Who can really blame them though. We know exactly what would happen to them if they were to include the practice of vaccination in their criticisms of Big Pharma.

“And there’s much greater awareness of how wrong – and how harmful – antivax beliefs really are.”

Is there? The AVN was formed in 1994 when vaccination rates were greatly lower than they are today, so how exactly are anti-vax beliefs harmful? Vaccination rates have increased significantly since the AVN was formed, so what is your argument exactly?

“This shift in attitudes has been followed by significant legislative change. Last year New South Wales introduced ‘No Jab, No Play’ rules. These gave childcare centres the power to refuse to enrol non-vaccinated children.

No, that’s not correct. While the Murdoch media was lobbying for such a legislative measure (why the hell is a newspaper engaged in lobbying anyway - that is not the media’s role) it failed. The New South Wales childcare laws which commenced last year provide for the registration of belief exemptions.

“In April the Abbott government introduced 'No Jab, No Pay' legislation. Conscientious objectors to vaccination could no longer access the Supplement to the Family Tax Benefit Part A payment. The payment has been conditional on children being vaccinated since 2012, as was the payment it replaced.”

That’s not entirely correct. Family Tax Benefit A supplement is paid for *every year* a parent is eligible to receive it. An immunisation requirement currently only applies to 3 of those years: the year a child turns one, two and five. No Jab No Pay seeks to extend the immunisation requirement to FTB A supplement for all ages up to 20.

“But until now vaccination refusers could still access the supplement by having a ‘conscientious objection’ form signed by a GP or claiming a religious belief exemption. The new legislation removes all but medical exemptions. The change closes loopholes that should never have been there in the first place. Claiming a vaccination supplement without vaccinating is rather like a childless person insisting on being paid the Baby Bonus despite being morally opposed to parenthood.”

Providing for belief exemptions is sound legislative practice not a loophole. It is incredibly unethical to pay people to submit their children to a medical procedure. Providing for belief exemptions ensures that only parents who really want to submit their children to the procedure will do so. It would be ethically corrupt for parents to be financially incentivised to submit their children to a medical procedure they are opposed to.

Family Tax Benefit A supplement is not a vaccination supplement, it’s a wealth redistribution measure. If FTB A supplement was a vaccination supplement, why is it paid every year up to the age of 20? So No, claiming FTB A supplement is not “rather like a childless person insisting on being paid the Baby Bonus despite being morally opposed to parenthood”. I do know that you and your fellow SAVN acolytes are fond of that particular analogy though. You think it's clever for some reason.

“The new rules also make the Child Care Benefit (CCB) and Child Care Rebate (CCR) conditional on vaccinating children. That’s not a trivial impost – estimates at the time of the announcement suggested some families could lose around $15,000 over four years. “

The impost is $15,000 per annum per child for those on maximum benefits.

“What should we make of this? A necessary response to an entrenched problem or a punitive overreaction?”

You really need to consider the answer to that question?

“A few antivaxxers even believe the germ theory of disease itself is false. In such cases no amount of time spent with a GP explaining the facts is going to help.”

Yes, which is the very reason the medical profession should keep the hell out of people’s lives unless invited in.

“They base their “choices” on beliefs ranging from the ridiculous to the repugnant.”

Would that be similar to how members of the SAVN, whose fully vaccinated children succumbed to the diseases they were vaccinated against, make the choice to convince others to use the same vaccines which failed their own children?

“In recent years, antivax activists have tended to frame their objections to legislation like No Jab, No Pay in terms of individual rights and freedom of choice. Yes, they base their “choices” on beliefs ranging from the ridiculous to the repugnant (including the claim that Shaken Baby Syndrome is really the result of vaccination not child abuse), but their fundamental objection is that the new policies are coercive. They make the medical procedure of vaccination compulsory, which they regard as a violation of basic human rights. Part of this isn’t in dispute – these measures are indeed coercive. Whether they amount to compulsory vaccination is a more complex question. In my view they do not because they withhold payments rather than issuing fines or other sanctions, though that can still be a serious form of coercive pressure.”

The Victorian SAR committee, which considered the Victorian No Jab No Play Bill, concluded that the Bill amounts to effective mandation or practical compulsion of vaccination for those reliant on child care services, so you and your fellow SAVNers need to stop claiming that these Bills are not removing choice when that's exactly what they are doing.

“However, the Committee notes that a parent who is unable to care for a child themselves (for example due to employment or other commitments) and cannot afford or otherwise obtain private care for their child (for example from a family member or a nanny) may have no choice other than to have his or her child vaccinated in order to enrol that child in an early childhood service.”

(page 10)

http://www.parliament.vic.gov.au/images/stories/committees/sarc/Alert_Digests/Alert_Digest_No_12_of_2015.pdf

“Such moves also have a disproportional impact on families who are less well-off, revealing a broader problem with using welfare to influence behaviour.”

No kidding.

“Nonetheless it’s not particularly controversial that the state can use some coercive power in pursuit of public health goals.”

The Commonwealth Bill does not prohibit enrolment in child care so it is a financial savings measure not a health protection measure. The Commonwealth Bill does not invoke its quarantine power, otherwise prohibition on enrolment would have been included in the Bill. The Bill has no capability of achieving public health goals, even if one was to believe vaccination furthered the public health in the first place.

“ It does so in a range of cases – from taxing cigarettes to fining people for not wearing seatbelts. Of course there is plenty of room for disagreement about how much coercion is acceptable.”

No there’s not. No amount of coercion is ever acceptable in relation to medical proceudures performed on otherwise healthy people.

“But vaccination doesn’t fall into the nanny state category because vaccination decisions aren’t just made by and for individuals. Several different groups rely on herd immunity to protect them. Herd immunity can only be maintained if vaccination rates within the community are kept at high levels. By refusing to contribute to a collective good they enjoy, vaccine users provide a classic example of the Free Rider Problem.”

Yet, at least 6 vaccines forming part of the immunisation requirement have no capability of providing a herd effect even if one believes in such nonsense. These include Hep B, IPV, Diphtheria, Tetanus, Whooping Cough, Hib.

http://thinkingmomsrevolution.com/an-open-letter-to-legislators-currently-considering-vaccine-legislation-from-tetyana-obukhanych-phd-in-immunology/

“No Jab, No Pay legislation is not about people making vaccination decisions for themselves, but on behalf of their children. The suggestion that parents have some sort of absolute right to make health decisions for their children just doesn’t hold water. Children aren’t property, nor are our rights to parent our children how we see fit absolute. No-one thinks the choice to abuse or starve one’s child should be protected, for example.”

How dare you use the examples of starvation and abuse as a comparator to non-vaccination. How morally corrupt can you get. No antivaxxer I know believes parental rights over children are absolute. Not one. Of course the state can step into the private sphere of family life under such circumstances of starvation and the like, but non-vaccination is not one of those occasions. You are a truly disgraceful person to represent non-vaccination on a similar plane as child neglect or abuse.

I’ll address the rest of your article later. There’s only so much one can take in a single dose.
18/10/2015 12:21:43 PM

yesu
The author does not touch on the possibility of deceit within these "science based" proofs.
18/10/2015 9:01:14 AM

Tristan
An article by the single worst philosopher in history. A man who one can only presume fails any of his students if they write essays who disagree with him (otherwise what is the point of this essay?)

Basically he is saying that if you have an opinion that gives poor ol' Patrick bad feelz it makes him cry and you therefore forfeit the right to have said opinion and the government should punish you.

The scary part is that amongst the group of miscreants at the SAVN Patrick is actually one of the less abhorrent ones.
17/10/2015 5:18:29 PM

Pavel Kalinov
Ah, right... a web site called "ethics" arguing we should take away people's basic rights cause we know better. G and read from the supplied link.
17/10/2015 5:13:17 PM

John Handley
"...and the sheer resilience of falsehood."

Yahoo! Not only on vaccination and climate change (hasn't warmed in 15/16/17/18/19 take your pick years), but on bicycle registration (rego pays for roads) and any number of other convenient fallacies. Great article.
17/10/2015 9:16:26 AM

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